Important note: Information in this article was accurate in 1995. The state of the art may have changed since the publication date.
Estimating the number of HIV transmissions through reused syringes and needles in the Mbeya Region, Tanzania.
AIDS. 1994 Nov;8(11):1609-15. Unique Identifier : AIDSLINE MED/95151240 Hoelscher M; Riedner G; Hemed Y; Wagner HU; Korte R; von Sonnenburg F; Department of Infectious Diseases and Tropical Medicine,; University of Munich, Germany.
Abstract:
OBJECTIVE: HIV infection attributable to medical injections is suspected to be low, although case-control studies have not provided definite results. This study aims to determine the number of HIV infections caused by the reuse of syringes and needles in the Mbeya Region, Tanzania. METHODS: The direct identification or detection of HIV in syringes and needles under field conditions was not appropriate, therefore a surrogate marker consisting of two components for possible HIV transmission was used: insufficient sterilization, and blood remaining from a previous patient. The assumption was that HIV infection can only occur if both markers are positive. Samples were collected in nine health-care facilities. All syringes and needles prepared for use in these facilities were collected without prior notification. The samples were rinsed and the resulting fluid was cultured for bacteria. Traces of blood were detected by urine stick test for haemoglobin volumes > 0.0015 microliters. RESULTS: Bacterial contamination was found in 32.8% of the total 1219 syringes and needles; 67% was caused by improper handling of the equipment after sterilization. Blood was detected in 12.5% of the samples. In the following three sampling strata, both contamination criteria were positive either on the syringe or the needle: wards/outpatient departments (OPD), 1.39%; laboratories, 7.45%; expanded programme on immunization (EPI), < 0.1%. We calculated that from 1.1 million patients injected in wards/OPD in any 1 year, fewer than 13 become infected, in laboratories fewer than 12 (160,000 blood-taking procedures), and less than one child in the EPI (850,000 vaccinations). CONCLUSION: With an established AIDS intervention programme supporting the health system, less than 0.4% of the total annual incidence of 4500-8500 is attributable to medical injections in the Mbeya Region.
Keywords: Case-Control Studies Community Health Services *Equipment Reuse Hospital Units Human HIV Infections/*EPIDEMIOLOGY/*TRANSMISSION HIV Seroprevalence Laboratories/STANDARDS *Needles Prevalence Sexually Transmitted Diseases Sterilization/STANDARDS Substance Abuse, Intravenous/EPIDEMIOLOGY Support, Non-U.S. Gov't *Syringes Tanzania/EPIDEMIOLOGY JOURNAL ARTICLE 950530
M9550575
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Important note: Information in this article was accurate in 1995. The state of the art may have changed since the publication date.
